Connolly Inc - Sr Auditor Resume Example

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Anthony Walker

XXX XXXXX XXXXXX, Clifton Heights, PA 19018

Ph: XXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Professional Summary:

Accomplished and energetic with a solid history of achievement. Strong ability to work well with all levels of staff. Motivated leader with solid organizational and prioritization abilities. Areas of expertise include Human Resources, People Management, Health care claims specialist, Inventory Management, and Call Center Management.

Service-oriented professional with over a decade of experience. Core competencies include Professionalism, ability to learn quickly as well as excellent communication and time management skills. Handles tasks with accuracy and efficiency.

Work Experience:

Sr. Auditor Jul 2014 －Aug 2014 Connolly Inc. Consohocken, PA Contract Position - Sr. Auditor

Demonstrates high ability strong analytical reasoning through the review of financial based information. Analyzes and identifies errors utilizing methodical techniques to solve problems.
Document concerns and make proposals to Management to avoid future reoccurrence.
Review financial statements, sales and activity reports, and other performance data to measure productivity and goal achievement and to determine areas needing cost reduction and program improvement.

Direct and coordinate activities of businesses or departments concerned with the production, pricing, sales, or distribution of products.

Direct and coordinate activities of businesses or departments concerned with the production, pricing, sales, or distribution of products.

Human Resource/Compliance Manager Aug 2012 －Mar 2013 Synergy Orthopedics Plymouth Meeting, PA

Direct and coordinate activities of businesses or departments concerned with the production, pricing, sales, or distribution of products.

Review financial statements, sales and activity reports, and other performance data to measure productivity and goal achievement and to determine areas needing cost reduction and program improvement.
Recruit, interview, perform background checks, and hire new staff as needed. Created and maintained HR files. Timely recording of State and Federal required forms

Serve as a link between management and employees by handling questions, interpreting and administering contracts and helping resolve work-related problems.

Advise managers on organizational policy matters such as equal employment opportunity and sexual harassment, and recommend needed changes.

Customer Service Representatives Jan 2008 －Jul 2010 Keystone Mercy Health Plan Philadelphia, PA

Oversee activities directly related to making products or providing services.

Review financial statements, claim activity/inventory reports, and other performance data to measure productivity and goal achievement and to determine areas needing cost reduction and program improvement.

Manage customer service, such as workforce managment/scheduling to ensure customer satisfaction as well an internal goal instructions on proceeding with claims submitted by healthcare providers.

Oversee insurance claims/adjustment processing or related documents and review them for accuracy and completeness.
Identify training opportunities with staff members and addressed as needed.
Coach and counsel staff as needed. Prepared or reviewed Performance Improvement plans where appropriate.

Manager, Operations Aug 1998 －Feb 2008 Independence Blue Cross Philadelphia, PA

Plan the flow of work or materials to maximize efficiency.

Develop or implement programs to address problems related to production, materials, safety, or quality.

Modify equipment or processes to improve resource or cost efficiency.

Interview benefits recipients at specified intervals to certify their eligibility for continuing benefits.

Train staff on the review of previously adjudicated claims and perform adjustments as appropriate.
Develop and train staff to perform adjustment, review and work provider's A/R. Created and implemented procedures to grant, modify, deny, or refer applicants to other agencies for assistance.

Develop and implement records management program for filing, protection, and retrieval of records, and assure compliance with program.

Analyze data gathered and develop solutions or alternative methods of proceeding.

Gather and organize information on problems or procedures.

Education: